Medicaid Waiver Guide – South Carolina

Understanding South Carolina Medicaid

South Carolina currently has seven Medicaid programs that can serve children, including a TEFRA program and six additional home and community based 1915(c) waivers. A new waiver for children with serious emotional disturbance was approved in 2020. All programs are based only on the child’s income, waiving parental income for eligibility. For more information about waivers in South Carolina that serve individuals with developmental or intellectual disabilities, see Medicaid HCBS Waiver Services from the Department of Disabilities and Special Needs. See also South Carolina Medicaid’s page on waivers.

Types of Programs

Katie Beckett TEFRA Children

• Description: Provides Medicaid coverage only.
• Online State Information: Katie Beckett TEFRA Children
• How to Apply: Apply for Healthy Connections online and then complete the additional forms for TEFRA.

Community Supports (CS) Waiver

• Description from medicaid.gov: Provides adult day health care services, personal care services, respite care services, waiver case management (WCM), incontinence supplies, adult day health care nursing, assistive technology and appliances assessment/consultation, assistive technology and appliances, behavior support services, career preparation services, community services, day activity, employment services, environmental modifications, in-home support services, personal emergency response systems (PERS), private vehicle assessment/consultation, private vehicle modifications, and support center services for individuals with intellectual disabilities, ages 0 to no max age.
• Online State Information: Community Supports Waiver and this Information Sheet
• Official Federal Information
• How to Apply: Call 800-289-7012 or see this Applying for Services page.

Medically Complex Children Waiver

• Description from medicaid.gov: Provides registered nurse care coordination, respite, environmental modifications, and pediatric medical day care for individuals who are medically fragile ages 0-21.
• Online State Information: Medically Complex Children Waiver
• Official Federal Information
• How to Apply: Call 1-888-971-1637 or online https://phoenix.scdhhs.gov/eref/

Head and Spinal Cord Injury (HASCI) Waiver

• Description from medicaid.gov: Provides attendant care/personal assistance services, career preparation services, day activity, residential habilitation, respite care, waiver case management, incontinence supplies, nursing services, occupational therapy, physical therapy, speech and hearing services, peer guidance for participant-directed care, behavioral support services, employment services, environmental modifications, health education for participant-directed care, independent living skills, personal emergency response systems, pest control bed bugs, pest control treatment, private vehicle assessment/consultation, private vehicle modifications, psychological services, specialized medical equipment/supplies/assistive technology – (assessment/consultation), and specialized medical equipment/supplies/assistive technology services to individuals with physical or other disabilities, or brain injury ages 0 or older who meet a nursing facility or ICF/IID level of care.
• Online State Information: HASCI Waiver and this Information Sheet
• Official Federal Information
• How to Apply: Call 800-289-7012 or see this Applying for Services page.

Intellectual Disability and Related Disabilities (ID/RD) Waiver

• Description from medicaid.gov: Provides adult day health care, adult day health care services, personal care 2, personal care 1, residential habilitation, respite care, waiver case management (WCM), adult dental services, adult vision, audiology services, incontinence supplies, nursing services, adult attendant care services, adult companion services, adult day health care nursing, behavior support services, career preparation services, community services, day activity, employment services, environmental modifications, independent living skills, personal emergency response system (PERS), pest control bed bugs, pest control treatment, private vehicle assessment/consultation, private vehicle modifications, specialized medical equipment and assistive technology assessment/consultation, specialized medical equipment, supplies and assistive technology, and support center services for individuals with intellectual disabilities, ages 0 to no maximum age.
• Online State Information: Intellectual Disability and Related Services Waiver and this Information Sheet
• Official Federal Information
• How to Apply: Call 800-289-7012 or see this Applying for Services page.

HIV/AIDS Waiver

• Description from medicaid.gov: Provides case management, personal care I, personal care II, attendant care services, companion care-agency, companion care- individual, home accessibility adaptations- environmental modifications, home delivered meals, Medicaid nursing – LPN, Medicaid nursing – RN, pest control, and specialized medical equipment and supplies for individuals with HIV/AIDS ages 0 – no max age.
• Online State Information: HIV/AIDS Waiver
• Official Federal Information
• How to Apply: Apply through Community Long Term Care (CLTC).

Palmetto Coordinated System of Care for Children (PCSC) Home and Community Based Waiver

• Description from medicaid.gov: Provides high fidelity wraparound, respite, and individual directed goods and services for individuals with serious emotional disturbance, ages 0-21 years.
• Online State Information: Palmetto Coordinated System of Care and Continuum of Care
• Official Federal Information
• How to Apply: For children with Medicaid already, call (888) 549-0820. Otherwise, follow the directions on this page.

Other online resources for South Carolina:

• South Carolina Autism Society helps with case management, referrals, education, and more
• Autism Spectrum Disorder Virtual Library has tons of information and research on ASD
• Family Connections will connection with other parents who have navigated the same issues as you

Telephone Resources

• Listed number for Intellectual Disabilities and Related Disabilities Waiver — (803/898-9671)
• Family Connection helpline has extra details on the waiver — 1-800-578-8750

Ordering Goally with a Medicaid Waiver

Talk with your case manager to see if the waiver program you have will cover Goally. If so, have your case manager email us at: [email protected] to place an order on your behalf.